目的 探讨伴中央颞区棘波的儿童良性癫痫（BECT）患儿认知功能与临床因素、脑电图痫样放电之间的相关性。方法 回顾性分析2019年1月至2022年7月行长程视频脑电图监测的BECT患儿的临床资料，另选取同期门诊行健康体检的健康儿童作对照组。对两组儿童进行中国修订-韦氏儿童智力量表测试，对比两组智商情况及分析BECT患儿临床因素和脑电图痫样放电与总智商（FIQ）、言语智商（VIQ）及操作智商（PIQ）之间关系。结果 纳入42例经典型BECT患儿，男18例、女24例，平均年龄（9.4±2.0）岁，平均起病年龄（7.4±2.6）岁。对照组45例，男28例、女17例，平均年龄（9.7±2.2）岁。与对照组相比，BECT组的FIQ、VIQ、VIQ子项中的分类和词汇以及PIQ中的木块图得分均较低，差异有统计学意义（P<0.05）。42例BECT患儿中，与≥10岁组相比，<10岁组患儿的FIQ和VIQ较低，差异有统计学意义（P<0.05）；脑电图不同放电侧别组之间VIQ差异有统计学意义（P<0.05），双侧放电组得分较低。BECT患儿起病年龄与FIQ（r=0.39）、VIQ（r=0.57）、VIQ子项中知识（r=0.49）、分类（r=0.35）、词汇（r_s=0.62）、领悟（r=0.43）、数字广度（r=0.37）得分呈显著正相关（均P<0.05），病程与VIQ子项中知识得分（r_s=-0.31）呈显著负相关（P<0.05）。与起病年龄≥10岁组相比，<10岁组VIQ子项中知识、词汇量表得分较低，差异有统计学意义（P<0.05）。左侧组、右侧组和双侧组之间VIQ子项中知识、数字广度量表得分的差异有统计学意义（P<0.05）。结论 BECT患儿平均智力水平处于正常范围，但智力结构存在不平衡现象，以语言功能受损为主，起病年龄早、双侧大脑半球放电、病程长是影响BECT患儿语言功能、导致认知功能下降的主要因素。

Objective To investigate the association of cognitive function and clinical factors with electroencephalogram epileptiform discharges in benign childhood epilepsy with centrotemporal spikes (BECT). Methods The clinical data of children with BECT monitored by long-term video electroencephalogram from January 2019 to July 2022 were retrospectively analyzed, and the healthy children who underwent physical examination in outpatient department during the same period were selected as control group. Chinese Revised Wechsler Intelligence Scale for Children (C-WISC) test was conducted in both groups of children. The intelligence quotient of the two groups was compared, and the relationship between clinical factors, electroencephalogram epileptiform discharges and total intelligence quotient (FIQ), verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ) in children with BECT were analyzed. Results A total of 42 patients (18 boys and 24 girls) with typical BECT were included, with an average age of (9.4±2.0) years and an average onset age of (7.4±2.6) years. The control group consisted of 45 healthy children, including 28 boys and 17 girls, with an average age of (9.7±2.2) years. FIQ, VIQ, scores of classification and vocabulary in VIQ sub-items, as well as wood block map in PIQ sub-items in BECT group were lower compared with the control group, with statistical significance (P<0.05). FIQ and VIQ in <10-year-old group were lower than those in ≥10-year-old group among 42 children with BECT, and the differences was statistically significant (P<0.05). There was a statistically significant difference in VIQ among different discharge side groups (P<0.05), and the score of bilateral discharge group was lower. The onset age of children with BECT was significantly positively correlated with FIQ (r=0.39), VIQ (r=0.57) and scores of knowledge (r=0.49), classification (r=0.35), vocabulary (r_s=0.62), comprehension (r=0.43) and digit span (r=0.37) in VIQ sub-items. The course of disease was significantly negatively correlated with the scores of knowledge (r_s=-0.31) in VIQ sub-items (P<0.05). Compared with the group with onset age ≥10 years old, the scores of knowledge and vocabulary in VIQ sub-items in the group with onset age <10 years old were lower, and the difference was statistically significant (P<0.05). There were statistically significant differences in the scores of knowledge and digit span in VIQ sub-items among left, right and bilateral groups (P<0.05). Conclusions The average intelligence level of BECT children is in the normal range, but there is an imbalance in the intellectual structure, mainly manifested as impaired language function. Early onset age, bilateral cerebral hemispheres discharges and long course of disease are the main factors that affect the language function and lead to the decline of cognitive function in children with BECT.